Bednarz, James E.

Caiani, Enrico G.

Collins, Keith A.

DeCara, Jeanne M.

Lang, Roberto M.

Mor-Avi, Victor

Weinert, Lynn

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Automated simultaneous echocardiographic quantification of myocardial perfusion and regional left ventricular function in patients post myocardial infarction 

454A ABSTRACTS - Noninvasive Imaging JACC March 19,2003 
(21%), anteroseptal (0%) and anterior (14%) segments. Conclusion: Use of HI with TEE mean 17.3 * 4.2. The best correlation between infarct area and no-deformation arc 
improves endocardial visualization and allows partial assessment of myocardial p&u- length in systole was r = 0.64, p c 0.05, for the baseline stage. 
sion, which may prove beneficial in the intraoperative setting. 
~~~~~ ~~~~~ 
7x 
2 
a-lb 
41% 
1188-33 Left Ventricular False Tendons: Echocardiographic 
Curiosity or Clinically Relevant? 
Satish Kenchaiah Emelia J. Benjamin, Jane C. Evans, Daniel Levy, Ramachandran S. 
Vasan, Framingham Hearl Study, Framingham. MA, Boston University School of 
Medicine, Boston, MA POSTER SESSION 
Background: Although Left ventricular false tendons (LVFT) are generally considered 1189 New Echocardiographic Methods for 
as normal anatomic variants, they have been associated with innocent precordial mur- 
murs, ventricular arrhythmias, and repolarization abnormalities in small case series. The 
Assessing Ventricular Function 
correlates of LVFT in the community are unknown. 
Methods: We examined the cross-sectional clinical, electrocardiographic (ECG), and 
echocardiographic (echo) correlates of LVFT in 101 subjects with LVFT (mean age 56, 
45% women) and 151 subjects without LVFT (mean age 57, 44% women) in the 
Framingham Heart Study. 
Results: After adjusting for age and sex, LVFT were associated with innocent precordial 
murmurs. ECG LV hyperirophy, and echo LV systolic dysfunction (Table). Body mass 
index was inversely related to the presence of LVFT. The relations between LVFT and 
precordial murmurs or ECG LV hypertrophy remained unchanged after further adjust- 
ment for body mass index. LVFT were not associated with hypertension, ECG ventricular 
premature beats or repolarization abnormalities, and echo LV mass, wall thickness, or 
diameter. 
Conclusions: In our community-based sample, LVFT were observed more commonly in 
lean subjects, likely due to better visualization. Our study confirms the association of 
LVFT with precordial murmurs, and identifies ECG LV hypertrophy and LV systolic dys- 
function as additional correlates not reported in prior literature. 
LVFT and Correlates 
Characteristic LVFT present LVFT absent p- 
(Il=lOl) (Il=151) value 
Body mass index (kg/mZ), means&D 
Innocent precordial murmurs (%) 
25.3k5.0 27.0r5.2 0.009 
9 
10 2 0.001 
3 
Ventricular premature beats on lo-second 4 2 0.33 
ECG rhythm strip (%) 
ECG-LV hypertrophy (%) 9 2 0.014 
LV ejection fraction ~50% (%) 10 4 0.049 
‘Adjusted for age and sex 
1188-34 Assessment of the Extent of lschemic Aneurysm as 
Defined by Curved M-Mode Analysis of Regional Strain 
Rate: An In Vivo Study in a Chronic Animal Model 
Julia C. Swanson, Sebastian T. Schindera, Michael Jones, Crispin H. Davies, Rosemary 
A. Rusk, David J. Sahn. Oregon Health & Science University, Portland, OR, NatIonal 
Heart, Lung & Blood Institute, Bethesda, MD 
Background: Strain rate imaging (SRI) appears to be sensitive to regional dysfunction in 
ischemic disease because it discriminates Intertarget deformation from tethered passive 
motion or cardiac motion. Methods: We studied 6 sheep (30-47kg) 6-10 weeks after 
LAD or diagonal occlusion was performed to produce a chronic ischemic aneurysm. 
Two-D TDI/SRI images were recorded using a GE/VingMed Vivid Five system. After 
study over 4 stages (baseline, metoprolol, dobutamine and transfusion of blood), the ani- 
mals’ hearts were arrested and removed for pathologic study. Digital TVI SRI loops were 
measured on a custom version of Echopac@ that allows derivation of curved M-modes 
displaying SRI color codes of yellow to red for compression, blue for expansion and 
grean for no defomlation. The arc lengths were measured and compared to the endocar- 
dial infarct zone area as a percent of total endocardial area at postmortem. Results: Inf- 
arct/aneurysm area ranged from 15.33%, mean 21.3 f S.l(SD) and no-deformation zone 
length as a measure of endocardlal length in the P-chamber view ranged from 7.26% 
Tuesday, April 01, 2003, NoonQ:OO p.m. 
McCormick Place, Hall A 
Presentation Hour: 1:OO p.m.-2:OO p.m. 
1189-35 Automated Simultaneous Echocardiographic 
Quantification of Myocardial Perfusion and Regional 
Left Ventricular Function in Patients Post Myocardial 
Infarction 
Victor Mar-Avi, Jeanne M. D&am, James E. Bednarz, Lynn ~einert, Keith A. Collins, 
Enrico G. Caiani, Roberto M. Lang, University of Chicago, Chicago, IL 
We tested the feasibility of an automated technique for objectwe, simultaneous assess- 
ment of myocardial perfusion and LV function in humans. Methods. We studled 8 
patients within 24h of primary PTCA after proximal LAD myocardlal infarction (Ml). Power 
modulation (PM) images were obtalned during iv infusion of Definity with prototype color- 
encoding of endocardial motion (Philips). Color information was used to obtain regional 
fractional area changes and automatlcally define myocardial regions of interest. Regional 
end-systolic PM Intensity was measured over time to calculate post-impulse steady-state 
contrast level and replenishment rate. An expert reader reviewed gray-scale images for 
visible perfusion defects and wall motion abnormalities. Results. 6/6 patients had perfu- 
sion defects accompanied by regional wall motion abnormalities: 4 showed no perfusion 
and 2 had “patchy” myocardial contrast. The remaining 2 patients showed delayed con- 
trast replenishment with normal wall motion. Contrast level and replenishment rate were 
61% and 51% lower in segments where perfusion defects were noted. In all patients with 
wall motion abnormalities, thin color bands were noted in hypokinetic segments, resulting 
in a 56% decrease in fractional area change. Conclusions. Contrast-enhanced, color- 
encoded PM images allow simultaneous, real-time imaging and quantitatwe analysis of 
myocardial perfusion and regional LV function, which may be useful to predtct functional 
recover in oatients oost MI. 
1189-36 Quantitative Assessment of Left Ventricular Myocardial 
Viability During Low Dose Dobutamine Stress 
Echocardiography in Combination With Color Tissue 
Doppler Imaging 
Hideil Tanaka, Tomotsugu Tabata, Eriko Kimura, Kenji Harada, Tetsuzo Wakatsuki. 
Takashi Yamamoto. Akihiro S&to. Kozo Uehara. Norihito Kaqevama, Takashl Oki, The 
University of Tokushima, Tokushima, Japan, The National Hiiashi - Tokushima Hospital, 
Tokushima, Japan 
Background: Myocardial viability in patients with myocardial infarction has been 
assessed by low dose dobutamine stress echocardiography @SE). Color tissue Doppler 
imaging (TDI) can optimize myocardial velocity profile (MVP) from endocardlum to epi- 
cardium: Non-isotropic averaging algorithm (PowerView, Toshiba Corp., Japan) was 
newly developed for obtaining stable MVP. 
Purpose: To quantitatively detect viable myocardial region using MVP dunng low dose 
DSE. 
Methods: Subjects consisted of 12 patients with previous myocardial infarction with 
myocardial contraction abnormality sclntigraphically ( 99mTc-MIBI) expected to have via- 
ble myocardium. Dobutamine was administered incrementaly by IO minutes interval (1, 
3, 5, 10, pglkglmin). Color TDI in parasternal short-axis view was recorded during DSE 


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Automated simultaneous echocardiographic quantification of myocardial perfusion and regional left ventricular function in patients post myocardial infarction

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